在心房隔膜缺陷穿皮关闭后无症状和轻度症状的成年人中提高运动能力
Marie-Claude Brochu1, Jean-François Baril, Annie Dore
1Montreal Heart Institute, Montreal, Quebec, Canada.
Circulation
|October 3, 2002
概括
在成年人中关闭心房隔膜缺陷 (ASD) 显著改善功能能力,即使在没有症状或较小的短路患者中也是如此. 这表明考虑对更广泛的成年人群进行ASD关闭.
科学领域:
- 心脏病学 心脏病学
- 成年人的先天性心脏病
- 干预心脏病学 干预心脏病学
背景情况:
- 无症状或轻微症状的成年人 (NYHA I或II类) 的第二次心房隔膜缺陷 (ASD) 存在关于关闭必要性的临床困境.
- 对于这些患者的最佳管理策略存在争议.
研究的目的:
- 评估通过皮肤关闭二次性ASD对成年患者功能能力和右心室尺寸的影响.
- 为了确定关闭是否有利于无症状或轻度症状的个体,那些较小的分流,和老年患者.
主要方法:
- 37名患有二次性自闭症的成年患者接受了穿皮关闭.
- 在手术前和手术后6个月,评估了最大氧气摄入量 (VO2max) 和右心室尺寸的回声心脏学测量.
- 患者按NYHA类,肺和系统流量比率 (Qp:Qs) 和年龄分层.
主要成果:
- 关闭6个月后,VO2max从平均23.5至26.9毫升/千克/分钟 (P<0.0001) 显著增加.
- 在所有子组中观察到VO2max的改善,包括NYHA类I和II,不同的Qp:Qs比率和年龄组 (>=40和<40岁).
- 右心室尺寸显著下降 (P<0.0001),大多数患者的病情有所改善,达到NYHA I级.
结论:
- 在成年人中,通过皮肤关闭自闭症导致功能能力显著提高.
- 自闭症关闭的好处扩展到无症状患者,那些较小的分流,和老年人.
- 这些发现支持考虑在成年人群中关闭ASD,即使没有明显的症状.
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